All of the following regarding rotavirus vaccine are correct except?

Available as monovalent and pentavalent

Last dose should be completed by 8 months of age

An 11-year-old child with a history of streptococcal pharyngitis presents you with fever and arthralgia. There is no past history of rheumatic heart disease or features of carditis or valvular disease. How often is 600,000 IU of benzathine penicillin recommended for prophylaxis of rheumatic heart disease?

Once in three weeks for 5 years or till the age of 18, whichever is longer

Once in three weeks for 10 years or till the age of 25, whichever is longer

An asymptomatic infant with a history of TB exposure, is 3 months old and had taken 3 months of chemoprophylaxis, what is to be done next?

Immunise with BCG and stop prophylaxis

Continue prophylaxis for 3 months

Rheumatic Heart Disease can be prevented by:

Treatment of respiratory infections in children

Screening of school going children

Vaccination against Streptococcus

Vaccine-Preventable Diseases for INI-CET: High-Yield Pediatrics Lessons

Diphtheria, Pertussis, Tetanus - Bacterial Blight Busters

Feature	Diphtheria	Pertussis	Tetanus
Agent	C. diphtheriae (G+ bacillus)	B. pertussis (G- coccobac.)	C. tetani (G+ rod, anaerobic)
Hallmark	Pseudomembrane, bull neck	Paroxysmal cough, "whoop"	Trismus, muscle spasms
Toxin Mech.	Inactivates EF-2	ADP-ribosylates Gi $\rightarrow$ $↑\text{cAMP}$	Blocks GABA/glycine release
Vaccine	Toxoid (D)	Acellular (aP) / Whole (wP)	Toxoid (T)

Diphtheria: Schick test for susceptibility.
Pertussis: Lymphocytosis common; culture on Bordet-Gengou/Regan-Lowe media.
Tetanus: Wound management crucial. Neonatal tetanus: unhygienic cord practices.

⭐ Tetanus: Spatula test positive (gag reflex absent, masseter spasm instead).

Measles, Mumps, Rubella, Polio - Viral Vanguard Vanquishers

Feature	Measles (Rubeola)	Mumps	Rubella (German Measles)
Agent	Paramyxovirus	Paramyxovirus	Togavirus
Rash	Mac-pap, ceph-caud, coalescent	-	Mac-pap, ceph-caud, discrete
Key Sign	Koplik spots (buccal); 📌 3C's (Cough, Coryza, Conjunctivitis)	Parotitis (bilateral)	Forchheimer spots (palate); Post. auricular/suboccipital LAD
Complication	Pneumonia (commonest death), OM, Encephalitis, SSPE	Orchitis (post-pubertal), Aseptic meningitis, Pancreatitis, Oophoritis	Congenital Rubella Syndrome (CRS: deafness, cataracts, PDA)
Vaccine	Live atten. (MMR)	Live atten. (MMR)	Live atten. (MMR)

⭐ Measles: Subacute Sclerosing Panencephalitis (SSPE) is a rare, fatal, late neurological complication.

Polio: Picornavirus (Enterovirus); fecal-oral. Mostly asymptomatic; can cause asymmetric flaccid paralysis (LMN). Vaccines: IPV (Salk-killed), OPV (Sabin-live attenuated - VAPP risk).

HepB, Hib, Rota, PCV - Modern Shield Squad

India UIP Immunization Schedule Infants, Children, Pregnant

Vaccine	Disease Prevented	UIP Schedule (Primary)	Booster Dose	Route	Notes / High-Yield
HepB	Hepatitis B, Cirrhosis, HCC	Birth (within 24h), 6, 10, 14 wks (Pentavalent)	Not routine in UIP	IM	📌 HepB at Birth! Monovalent at birth.
Hib	H. influenzae type b: Meningitis, Epiglottitis	6, 10, 14 wks (Pentavalent)	16-18 months	IM	📌 Hi bye to meningitis! Part of Pentavalent.
Rotavirus	Severe Infantile Diarrhea (Rotavirus GE)	6, 10, 14 wks (e.g., Rotavac, Rotasiil)	None	Oral	> ⭐ Slight risk of intussusception (esp. 1st dose, within 7 days).
PCV	Pneumococcal disease (Pneumonia, Meningitis)	6, 10, 14 wks (PCV13)	9-12 months	IM	Protects against S. pneumoniae; reduces otitis media.

BCG, Varicella, JE, Typhoid - Contextual Champions

BCG (Bacillus Calmette-Guérin)
- Live attenuated (Danish 1331). Dose: 0.05mL (<1mo), 0.1mL (≥1mo) ID, left upper arm.
- Scar: Papule (2-3w) → Ulcer (6-8w) → Scar (8-12w).
- ⭐ BCG protects against severe childhood TB (meningitis, miliary), not primary infection or adult pulmonary TB.
- Contra: Immunodeficiency. Complication: BCG-osis/lymphadenitis.
Varicella (Chickenpox)
- Live attenuated (Oka strain). 0.5mL SC.
- Schedule: 15mo, 4-6yr. Post-exposure: Vaccine (3-5d); VZIG for high-risk.
JE (Japanese Encephalitis)
- Live (SA 14-14-2) or Killed. NIP (endemic areas): 9-12mo, 16-24mo.
- High fatality (20-30%); neuro sequelae. Vector: Culex mosquitoes.
Typhoid
- Vi Polysaccharide (ViPS): ≥2yr, 0.5mL IM. Booster q3yr.
- Oral Ty21a: ≥6yr, 3-4 doses. Booster q3-5yr. For travelers, endemic areas.
- Efficacy 50-80%.

High‑Yield Points - ⚡ Biggest Takeaways

Live vaccines (MMR, OPV) contraindicated in immunocompromised & pregnancy.

Killed vaccines (IPV) safer in immunocompromised; may have ↓ immunogenicity.

India's Pentavalent vaccine includes DPT, Hep B, and Hib.

Measles vaccine at 9 months with Vitamin A; second dose at 15-18 months.

BCG vaccine (intradermal) protects against severe TB (meningitis, miliary); leaves a scar.

Rotavirus vaccine (oral) prevents severe childhood diarrhea.

PCV prevents invasive Streptococcus pneumoniae disease.

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Vaccine-Preventable Diseases